The key to creating a healthcare environment that patients want to keep coming back to is found in two words: patient engagement.
Patient engagement is probably one of the most misunderstood and controversial recent buzzwords in healthcare. Depending on who you are, patient engagement is either the second coming of healthcare or another pesky hurdle for providers to overcome. Furthermore, it can have a different meaning depending on who you ask.
Policy leaders define it as “lowering costs by increasing operational efficiencies and quality of care.” Entrepreneurs define it as “finding inefficiencies and bringing value through products or services.” Providers define it as “beneficial to overall patient outcomes and care, but with a negative return on investment (ROI),” because they see it as more unreimbursed time. And finally, patients define it as “improved access and convenience.”
However it is defined, there is clearly a cultural shift happening in healthcare today with the consumerization of the patient experience. The concept of an on-demand economy is invading every business sector, and healthcare is no exception. While the change in expectations is being driven by big companies like Apple and Uber, it is putting pressure on providers running independent practices.
Many doctors are wary of the term “patient engagement” because they see it as a loss leader. In fact, according to a 2014 HIMSS study, physicians named lack of reimbursement, as well as time constraints, as the primary barriers to increasing patient engagement.1 Engagement platforms, such as those created by Kaiser Permanente or the Palo Alto Medical Foundation, came at a considerable expense and at levels that are cost prohibitive for independent practices that don’t have multimillion-dollar budgets or dedicated IT departments to maintain such systems.
Plenty of research and real-life experience has taught the industry what patients want: to be able to go online and email their doctor, book an office visit, see physician reviews, get appointment reminders, and view their medical records. But it isn’t clear for many how a small practice physician can get reimbursed for taking the time to digitally communicate with patients – not to mention how to obtain ROI from investing in these technologies.
However, there are some clear returns when practices invest time and money into a patient engagement and practice-marketing platform. The most significant is the reduction of no-shows by sending text and email reminders. A secondary benefit is that visit surveys, which can be syndicated on a variety of online review sites, can also be sent after the appointment. This cycle of electronic communications not only brings convenience to the patient and reduces lost revenue, but it also has a positive impact on the practice’s online reputation. As a result, the practice is better positioned to increase new patients who are searching online for a provider.
According to Google, over 75 percent of patients search online before making an appointment with a medical provider. Doctors, practice administrators, and CIOs should be looking at digital marketing to attract new patients, retain existing ones, and grow their practice. Smaller practices can gain as much as 20 percent of their new patients from online sources.
A new wave of cloud-based technologies is offering independent practices ways to engage with patients effectively online and on their mobile devices as well as to market their practices better on the Internet and social media. Effective, profitable patient engagement through digital marketing at any size practice really boils down to the “3 Rs”: reminders, reviews, and recare.
Patients want doctors who offer email and text reminders because they know reminders make it more likely for them to not forget about their appointment. Studies done on appointment reminders suggest that they can reduce no-shows anywhere from 30 to 50 percent. For the average primary care practice, this equates to about one appointment per day per provider. In a three-provider practice, reminders would prevent the loss of about $75,000 to $100,000 per year.
Setting up effective reminders is a combination of people, process, and technology. Practices should have fully trained staff who know how to create automated text and email appointment reminders. For example, Westgate Skin and Cancer, a solo practitioner dermatology office in Austin, TX, has a very effective mix of sending email reminders two days before a patient appointment followed by a text message reminder two hours before the actual appointment. This has resulted in an impressive 70 percent reduction in patient no-show rates.
Reviews are a very important consideration when looking toward online patient engagement and marketing. Professor Michael Luca at Harvard Business School published a study about this called “Reviews, Reputation, and Revenue: The Case of Yelp.com.” An interesting statistic he found shows that where Yelp reviews penetrated a local market, the business of chain restaurants declined because consumers began trying more independent businesses as they gained confidence about their quality. This is an exciting statistic, as it points to a strong opportunity for independent practices to compete effectively against larger health systems by embracing an aggressive and effective positive reviews strategy. The survey also found that an increase in star rating can be tied to an increase in revenue – a one-star increase equated to a 9 percent increase in revenue.
The final “R” of effective engagement is recare. At its heart, recare is a method to engage patients by reminding them to come in for office visits or routine regular checkups. Recare messages should be done through emails – not text – as they lack the immediacy of an appointment reminder. Take great care in testing how your recare messages appear to patients on iPhones and Android phones, since many people now read most email on their smartphone.
Make sure the subject line is straightforward and to the point. It should tell the reader what is inside the email, not sell the reader the content. Subject lines can make a significant difference in the open rate of recare emails. Most people will assume a subject line that reads like an advertisement will be spam. You want your patients to know the message is from your clinic and not just random junk mail.
There are two types of recare messages – those that are generic and those that are condition specific. Many reminder systems allow your office to send mass emails such as newsletters, or send patients an annual, bi-annual, or more frequent series of reminders to book an appointment for an office visit. There are more sophisticated types of recare systems that will read the chart or billing data in an EHR or practice management system and send your patients unique, condition-specific recare messages. For example, a Type 2 diabetes patient could receive a series of diet or medication reminders. While independent practices can use the first type of generic recare messaging well, condition-specific recare messages for smaller practices are still in their relative infancy as an industry or feature set.
There is a question of whether or not condition-specific recare messages may create more workload for practices. Condition-specific messages may prompt patients to ask continued questions to the provider, and in manners that are not compensated or reimbursable for the practice. Because this feature is still a relatively new field, the data emerging is not yet conclusive.
Even if condition-specific recare software isn’t available for small practices, some doctors send out seasonal messaging to fit the needs of their clientele, while others send out messages to patients on their birthdays. Seasonal recare messages are great for reminding patients about flu season and safe summer fun. Practices can also use birthday recare messages to remind patients of health checks that happen around their milestone birthdays, such as a prostate exam email for men on their 50th birthday.
Ideally, the 3 Rs work together to keep your patients connected to your practice, improve their satisfaction, and potentially improve wellness and outcomes. In addition, by encouraging those patients to review your practice, new patients are more likely to choose your practice over one that isn’t offering options to meet changing patient needs and expectations.
Patient engagement is incredibly important for medical practices to consider in today’s healthcare landscape for other reasons as well. The potential ROI will only grow as value-based reimbursement continues to expand and practices look to take advantage of programs like chronic care management. It will also play an important role in increasing patient loyalty as practices strive to remain independent and stand out from competing retail clinics and hospital-owned practices.
Reference
Metrics
HIMSS Value Score is next-gen health IT
analytics tool
If you are looking for ways to qualify and quantify your health IT efforts and spend across departments, divisions, and the whole enterprise, the Healthcare Information and Management Systems Society (HIMSS) is on your wavelength.
The HIMSS Value Score, the latest generation of several HIMSS-developed standards and resources, is billed as “healthcare’s first international quality measurement for the value of health IT” and aims to “give providers a way to look at their entire organization and capture a 360-degree view of how they achieve value beyond the electronic health record.” It’s a natural development for C-suite leaders who have turned to HIMSS throughout the years for insights and guidance on how to use IT optimally to tackle today’s challenges and prepare for those to come. In the long term, it should help users optimize and use IT to improve clinical and financial outcomes, and drive efficiencies in care.
But how can it help in the real world? Pat Wise, R.N., Vice President of HIMSS, gives the following example: Two organizations could be Stage 7. However, their Value Score could be significantly different based on how they are utilizing HIT to drive clinical, financial, and operational outcomes. In another scenario, a Board of Directors could use the Value Score to understand the extent to which executive management is optimizing outcomes. The converse is also true: The C-suite could use the Value Score to demonstrate to the Board of Directors how investment in HIT is being realized.
The Value Score is the next generation of several HIMSS-developed standards and resources that have served as the leading health IT adoption models for providers over the last decade. For example, HIMSS Analytics’ EMRAM has helped hospitals and clinical practices track and benchmark their EMR adoption and utilization goals since 2005. The HIMSS Health IT Value Suite and Value STEPS, released in 2013, have provided both a framework and vocabulary for providers to articulate their value strategy. They offer thousands of entries and more than 900 detailed case studies that can provide strategies, tactics, and measures used to document value.
HIMSS developed the guidelines for the Value Score and is currently refining the scoring algorithm across provider organizations in the United States and abroad, including HIMSS’ Davies Award winners and small critical access hospitals. The results for this initial pilot group will include actionable data sets and scores.
Upon entering the next phase of technology and innovation, healthcare will need a new, truly universal standard and model for value. HIMSS says that its Value Score will “fill that void.”
